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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 12/05/2024
Date Signed: 12/05/2024 01:23:44 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/20/2024 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20240220120353
FACILITY NAME:BEVERLY HILLS TERRACEFACILITY NUMBER:
198603319
ADMINISTRATOR:STRIKS, AHARONFACILITY TYPE:
740
ADDRESS:1470 S ROBERTSON BLVDTELEPHONE:
(310) 273-3668
CITY:LOS ANGELESSTATE: CAZIP CODE:
90035
CAPACITY:110CENSUS: 60DATE:
12/05/2024
UNANNOUNCEDTIME BEGAN:
12:11 PM
MET WITH:Cesilia TorresTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff are coecing resident into using the facilities medical services.
Staff are preventing resident from being seen by her physician.
Staff did not keep resident's personal information confidential.
Staff had residents inappropriately sign a document.
Staff are mishandling resident's finances.
Staff did not allow resident's vistor in her room.
INVESTIGATION FINDINGS:
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On 02/26/24, at 9:00am, Licensing Program Analyst (LPA) Mario Leon conducted an initial complaint visit to the facility and was greeted by Cesilia Torres, Assistant Administrator. LPA explained the purpose of this visit is to conduct interviews, gather facility files, and render findings in the complaint.

The investigation consisted of the following: The department investigated the allegation mentioned in this complaint and conducted interviews with staff (S1-S2) and residents (R1-R6). Additionally, the department obtained the following documents: Resident Roster (No Date), Staff Roster (Dated: 07/2024), Admission Agreement (Dated: 07/20/2021), Physician’s Report (Dated: 02/06/2024), Appraisals/Needs and Services Plan (Dated: 01/30/2024), Identification and Emergency Information (Dated:11/28/2009) and an Internal document signed by resident R1 (Dated: 01/10/2024) from the facility.


Complaint Investigation Report Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 11-AS-20240220120353
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: BEVERLY HILLS TERRACE
FACILITY NUMBER: 198603319
VISIT DATE: 12/05/2024
NARRATIVE
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The investigation revealed the following: Allegation #1-Staff are coercing resident into using the facilities medical services.

The details of the complaint alleged that the facility staff are coercing resident (R1) into using their in-house doctor and not giving the resident a choice to use R1s own doctor. On 02/26/24, from 09:30am-3:00pm, the department interviewed staff (S1-S2) and residents (R1-R6) regarding the allegation. 2 of 2 staff (S1- S2) denied the allegation that the facility Staff are coercing resident into using the facilities medical services. All staff (S1-S2) stated that the facility does not coerce residents into using their in-house doctors. They state that it is offered as a convenience because some residents do not like to go out and other residents’ doctors are far away. Staff (S1) stated that (R1) used to see R1s primary doctor but recently R1 wasn’t feeling well. R1 requested to see our in-house doctor, because R1 said R1 was having difficulty seeing R1s doctor. We called the relative to let them know of the new doctor but the relative claims no responsibility. The staff states that all residents have a choice in choosing the doctor of their choice.

The department interviewed residents R1-R6 about the allegation and 5 of 5 residents that were interviewed denied the allegation that Staff are coercing resident into using the facilities medical services. The majority (5 of 6) residents interviewed stated that the facility does not coerce them into using the facilities in-house doctors and that they do have a choice in choosing what doctors they see.

Based on interviews, there is insufficient evidence to support the allegation that the Staff are coercing resident into using the facilities medical services. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is Unsubstantiated.

Allegation #2- Staff are preventing resident from being seen by their physician.

The details of the complaint alleged that the facility is preventing the resident (R1) from seeing their own doctor and keeps pushing them into using the in-house doctors. On 02/26/24, from 09:30am-3:00pm, the department interviewed staff (S1-S2) and residents (R1-R6) regarding the allegation. 2 of 2 staff (S1- S2) denied the allegation that the facility Staff are preventing resident from being seen by her physician. All staff (S1-S2) stated that the facility did not prevent the resident from seeing their doctor. They state that the resident (R1) made a choice to use their in-house doctor because it was more convenient. The department reviewed an Internal document signed by resident R1 (Dated: 01/10/2024) that stated that R1 made the decision on their own to see the in-house doctor and to use the facilities Home Health Services voluntarily.

The department interviewed residents R1-R6 about the allegation and 5 of 5 residents that were interviewed denied the allegation that Staff are preventing resident from being seen by their physician. The majority (5 of 6) residents interviewed stated that they chose to use the facilities in-house doctors voluntarily and was not forced by the staff.

Complaint Investigation Report Continued on LIC9099-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 11-AS-20240220120353
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: BEVERLY HILLS TERRACE
FACILITY NUMBER: 198603319
VISIT DATE: 12/05/2024
NARRATIVE
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Based on interviews and records reviewed, there is insufficient evidence to support the allegation that the Staff are preventing resident from being seen by their physician. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is Unsubstantiated.

Allegation #3- Staff did not keep resident's personal information confidential.

The details of the complaint alleged that the facility shared the resident (R1) personal information with other residents. On 02/26/24, from 09:30am-3:00pm, the department interviewed staff (S1-S2) and residents (R1-R6) regarding the allegation. 2 of 2 staff (S1- S2) denied the allegation that the facility Staff did not keep resident's personal information confidential. All staff (S1-S2) stated that the facility does not and did not share R1s personal information with other residents. They state that two residents witnessed R1 signing a document that stated that R1 wanted to use the in-house doctor and the facilities Home Health Services voluntarily. They state that no personal information was provided or seen by the residents. The department reviewed an Internal document signed by resident R1 (Dated: 01/10/2024) that stated that R1 made the decision on their own to see the in-house doctor and to use the facilities Home Health Services voluntarily. Two staff and two witnesses also signed the document, and no confidential personal information was indicated in the document.

The department interviewed residents R1-R6 about the allegation and 5 of 5 residents that were interviewed denied the allegation that Staff did not keep resident's personal information confidential. The majority (5 of 6) residents interviewed stated that the facility has not shared any of their personal information or other residents’ information with them.

Based on interviews and records reviewed, there is insufficient evidence to support the allegation that the Staff did not keep resident's personal information confidential. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

Allegation #4- Staff had residents inappropriately sign a document.

The details of the complaint alleged that the facility staff had the resident (R1) sign a document inappropriately. On 02/26/24, from 09:30am-3:00pm, the department interviewed staff (S1-S2) and residents (R1-R6) regarding the allegation. 2 of 2 staff (S1- S2) denied the allegation that the facility Staff had residents inappropriately sign a document. All staff (S1-S2) stated that the facility does not have any resident sign any paperwork or documents that is inappropriate. They state the document in question was a document signed by the resident (R1) declaring their intent to use the in-house doctors. They state that the resident new what the document was and why they were signing it and in no way was it an inappropriate document to sign.

Complaint Investigation Report Continued on LIC9099-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 11-AS-20240220120353
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: BEVERLY HILLS TERRACE
FACILITY NUMBER: 198603319
VISIT DATE: 12/05/2024
NARRATIVE
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The department reviewed an Internal document signed by resident R1 (Dated: 01/10/2024) that stated that R1 made the decision on their own to see the in-house doctor and to use the facilities Home Health Services voluntarily.

The department interviewed residents R1-R6 about the allegation and 5 of 5 residents that were interviewed denied the allegation that Staff had residents inappropriately sign a document. The majority (5 of 6) residents interviewed stated that the facility has never had them sign documents that were inappropriate.

Based on interviews and records reviewed, there is insufficient evidence to support the allegation that the Staff had residents inappropriately sign a document. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

Allegation #5- Staff are mishandling resident's finances.

The details of the complaint alleged that the facility is mishandling the residents (R1) finances. On 02/26/24, from 09:30am-3:00pm, the department interviewed staff (S1-S2) and residents (R1-R6) regarding the allegation. 2 of 2 staff (S1- S2) denied the allegation that the facility Staff are mishandling resident's finances. All staff (S1-S2) stated that the facility does not handle R1s finances and that R1 handles their own finances. They state that when it is time for the resident to pay their rent, R1 writes out the check and gives it to administration to cash. They state at no time have they ever mishandled R1s finances because R1 handles their own.

The department interviewed residents R1-R6 about the allegation and 5 of 5 residents that were interviewed denied the allegation that Staff are mishandling resident's finances. R1 stated that R1 handles their own finances and banking. The majority (5 of 6) residents interviewed stated that the facility has not mishandled their finances.

Based on interviews, there is insufficient evidence to support the allegation that the Staff are mishandling resident's finances. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

Allegation #6- Staff did not allow resident's visitor in their room.

The details of the complaint alleged that the facility does not allow the resident to have visitors in their room. On 02/26/24, from 09:30am-3:00pm, the department interviewed staff (S1-S2) and residents (R1-R6) regarding the allegation. 2 of 2 staff (S1- S2) corroborated the allegation that the facility Staff did not allow resident's visitor in her room. All staff (S1-S2) stated that they’re allowed to have visitors but only in the patio area or the T.V. room. They are allowed to go out over the weekend with their family as well. Rooms are shared, that’s why they meet on the patio or the T.V. room.

Complaint Investigation Report Continued on LIC9099-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 11-AS-20240220120353
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: BEVERLY HILLS TERRACE
FACILITY NUMBER: 198603319
VISIT DATE: 12/05/2024
NARRATIVE
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The department interviewed residents R1-R6 about the allegation and 5 of 5 residents that were interviewed corroborated the allegation that Staff did not allow resident's visitor in her room. The majority (5 of 6) residents interviewed stated that they are allowed visitors but not in their rooms because the rooms are shared, and they don’t want to disturb their roommates. They state that visitors are welcomed in the patio area or the television room.

Based on interviews, there is sufficient evidence to support the allegation that the Staff did not allow resident's visitor in her room. However, the reason for that is that the residents’ rooms are shared, and they will not have any privacy. Visitors are instructed to visit in the patio area or the television room; therefore, the allegation is Unsubstantiated.

No citations were issued for this complaint.

An exit interview was conducted with Cesilia Torres, Assistant Administrator, and a copy of this Complaint Investigation Report was provided.


SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5